Individual
DR. KIRBY P CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4006 JOHNATHAN ST, WATERLOO, IA 50701-9387
(319) 236-2700
Mailing address
PO BOX 2758, WATERLOO, IA 50704-2758
(319) 235-5390
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036126457
IL
2085R0202X
Diagnostic Radiology Physician
Primary
35956
IA
2085R0202X
Diagnostic Radiology Physician
42049-20
WI
Other
Enumeration date
06/02/2006
Last updated
11/21/2023
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